hypofractionated image guided radiation therapy in treating patients with stage iv breast cancer

Conditions: Central Nervous System Metastases; Invasive Ductal Breast Carcinoma; Invasive Ductal Breast Carcinoma With Predominant Intraductal Component; Invasive Lobular Breast Carcinoma; Invasive Lobular Breast Carcinoma With Predominant in Situ Component; Liver Metastases; Lobular Breast Carcinoma in Situ; Lung Metastases; Male Breast Cancer; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Recurrent Breast Cancer; Stage IV Breast Cancer; Tubular Ductal Breast Carcinoma; Tumors Metastatic to Brain

Summary: this pilot clinical trial studies new ways to monitor the impact of hypofractionated image guided radiation therapy in treating patients with stage iv breast cancer. radiation therapy uses high energy x rays to kill tumor cells. giving radiation therapy in different ways may kill more tumor cells.


Eligibility criteria:
inclusion criteria: * histologically or cytologically proven diagnosis of breast cancer (invasive ductal, lobular, medullary, papillary, colloid, tubular) * completion of standard of care treatment for local and regional disease with no known residual * american joint committee on cancer (ajcc) (6th edition, 2002) stage iv ( any t, any n, m1) based upon the following minimum diagnostic workup: * history/physical examination within 8 weeks prior to registration * computed tomography (ct), magnetic resonance imaging (mri) and/or positron emission tomography (pet) ct of the whole body within 60 days prior to registration * mri of the brain, if clinically indicated * documentation of 1-5 sites of metastatic tumor; each individual site of tumor must be =\< 10 cm or \< 500 cc volume and amenable to radiation therapy as seen on standard imaging (ct, mri, bone scan) * pathology from at least one metastatic site confirming breast primary is recommended * zubrod performance status =\ = 60%) * absolute neutrophil count (anc) \>= 1,800 cells/mm\^3 * platelets \>= 100,000 cells/mm\^3 * hemoglobin \>= 8.0 g/dl (note: the use of transfusion or other intervention to achieve hemoglobin \[hgb\] \>= 8.0 g/dl is acceptable) * total bilirubin within institutional limits * albumin \> 2.9 g/dl * alkaline phosphatase \< 2.5x upper limit of normal (uln) * aspartate aminotransferase (ast) and alanine aminotransferase (alt) \< 2.5 x uln * room air saturation (saturated oxygen \[sa02\]) \> 90% * life expectancy \> 3 months * patient complete study specific informed consent process and sign consent form prior to study entry * patients with prior metastatic treatment are eligible if they have been disease free for \> 3 years; participants may receive hormonal and herceptin treatment at any time exclusion criteria: * patients are ineligible if they have had prior treatment for their metastatic disease within 3 years * prior radiotherapy that would result in overlap of radiation therapy fields * co-existing or prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) * severe, active co-morbidity, defined as follows: * clinically significant pulmonary dysfunction, cardiomyopathy, any history of clinically significant congestive heart failure (chf), unstable angina pectoris, or cardiac arrhythmia * transmural myocardial infarction within the last 6 months * acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration * chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration * hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for liver function and coagulation parameters are not required for entry into this protocol * acquired immune deficiency syndrome (aids) based upon current centers for disease control (cdc) definition; note, however, that human immunodeficiency virus (hiv) testing is not required for entry into this protocol; the need to exclude patients with aids from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive; protocol-specific requirements may also exclude immunocompromised patients * pregnancy, breast feeding or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception during treatment and for at least three months following completion; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic * prior treatment with anti-angiogenic therapy * significant atelectasis such that ct definition of the gross tumor volume (gtv) is difficult to determine * exudative, bloody or cytologically malignant effusions * evidence of pleural or pericardial effusion prior to study start; patients with pleural effusion that is transudative, cytologically negative, and non-bloody are eligible; if a pleural effusion is too small for diagnostic thoracentesis, the patient will be eligible